Sex difference in clot lysability and association to coronary artery calcification

Ramanathan, Ramshanker; Sand, Niels Peter Rønnow; Sidelmann, Johannes Jakobsen; Nørgaard, Bjarne Linde; Gram, Jørgen Brodersen

doi:10.1186/s13293-018-0168-8

Cited by 9 publications

(6 citation statements)

References 40 publications

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“…A sex‐specific effect on absolute values of clot lysis was previously observed. Thus, a prolonged lysis time was seen in women compared to men with type 2 diabetes, 37 coronary artery disease, 39 atrial fibrillation, 40 and asymptomatic coronary artery calcification 41 and this might be mediated by increased incorporation of PI into the fibrin clot in women compared with men 30 . In our study, sex was also an independent predictor of changes in PI, cautiously suggesting a more antithrombotic effect of obesity surgery in men than in women.…”

Section: Discussionsupporting

confidence: 55%

Reductions in plasmin inhibitor and fibrinogen predict the improved fibrin clot lysis 6 months after obesity surgery

et al. 2020

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Summary Prothrombotic and metabolic variables are decreased after obesity surgery, and fibrin clot lysis is increased. It is unknown how fibrinolytic variables are affected, and whether fibrinolytic and metabolic changes predict the enhanced clot lysis. Study aims were to determine fibrinolytic biomarkers before and 6 months after Roux‐en‐Y gastric bypass (RYGB) and to identify predictors of the RYGB‐induced increase in clot lysis. Women (n = 42) and men (n = 18) with obesity underwent RYGB, and factor XIII (FXIII), thrombin activatable fibrinolysis inhibitor (TAFI), plasminogen and plasmin inhibitor (PI) were measured before and 6 months after surgery. Regression analyses identified determinants of the RYGB‐induced increase in clot lysis among changes in fibrinogen and in fibrinolytic and metabolic variables. Results showed that after RYGB, FXIII, TAFI, plasminogen and PI were reduced (P < .0005). Reductions in PI (β = −0.59) and fibrinogen (β = −0.35), together with age (β = −0.22) and male sex (β = 0.22), predicted the enhanced clot lysis with the model explaining 56% (P < .0005). Predictors of the reduction in PI were reductions in cholesterol (β = 0.37) and glucose (β = 0.29), together with male sex (β = −0.28), whereas reductions in fibrinogen were predicted by lowering of interleukin‐6 (IL‐6) (β = 0.32). In conclusion, fibrinolytic variables were reduced 6 months after RYGB. Targeting PI and fibrinogen, by reducing metabolic variables such as glucose, cholesterol and IL‐6, has a profibrinolytic effect in obesity.

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Section: Discussionsupporting

confidence: 55%

Reductions in plasmin inhibitor and fibrinogen predict the improved fibrin clot lysis 6 months after obesity surgery

et al. 2020

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“…↓ in CAD vs healthy controls [95,96] and cardiac transplant recipients with CAD vs no CAD [73] Global fibrinolytic capacity a ↓ in CAD vs healthy controls [97] a Plasma + tPA added to standardized fibrin tablet, fibrin D-dimer generation measured.…”

Section: Global or Dynamic Assaysmentioning

confidence: 99%

Fibrin clot properties in coronary artery disease: new determinants and prognostic markers

Larsen¹,

Hvas²

2021

Polish Archives of Internal Medicine

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Despite improved diagnosis and treatment options, coronary artery disease (CAD) is still a leading cause of mortality and morbidity worldwide. Established risk factors as smoking, hypercholesterolemia, and hypertension only partly explain the pathophysiology of CAD.Besides the well-known role of platelets in atherosclerosis and arterial thrombus formation, reduced endogenous fibrinolytic activity may play a key role for CAD formation and progression. Thus, biomarkers of fibrinolysis may be future CAD risk markers. In this review we provide an overview of regulators of fibrinolysis and the main factors of importance to fibrin clot formation including coagulation factor XIII, thrombin and fibrinogen. We summarize markers of altered fibrinolysis and current laboratory methods applied in clinical practice and research. We present today's evidence on fibrin clot properties in patients with stable CAD or acute coronary syndrome compared to healthy individuals and the significance of altered fibrinolysis as a risk for coronary thrombotic disease. In conclusion, we find evidence that altered fibrin clot properties and impaired fibrinolysis appears to contribute significantly to the thromboembolic risk in CAD patients. Therefore, more research is crucial in order to clarify whether modulation of the fibrinolytic system may pave the way for improved treatment of CAD.

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“…In the present study, only STZ-female mice treated with CANA exhibited an increased level of βHB, which is consistent with clinical data 62,68 . Fibrinolysis differed between Contr male and female mice, both normoglycemic and hyperglycemic, which indicates that fibrinolysis is sex dependent regardless of the glycemic condition [69][70][71] . The improvement in fibrinolysis after both CANA and DAPA administration was observed only in female mice.…”

Section: Discussionmentioning

confidence: 97%

Sex-dependent effects of canagliflozin and dapagliflozin on hemostasis in normoglycemic and hyperglycemic mice

Marcińczyk

Misztal²,

Chabielska³

et al. 2023

Sci Rep

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Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are antihyperglycemic drugs that decrease mortality from cardiovascular diseases. However, their effects on hemostasis in the cardioprotective effects have not been evaluated. Therefore, the effects of canagliflozin (CANA, 100 mg/kg, p.o.) and dapagliflozin (DAPA, 10 mg/kg, p.o.) on the parameters of hemostasis were investigated in female and male normoglycemic and streptozotocin (180 mg/kg, i.p.)-induced diabetic mice. CANA and DAPA reduced platelet activity in thrombus in male and female mice both normoglycemic and diabetic. CANA decreased thrombus formation in diabetic male mice, and platelet activation to ADP in diabetic female and male mice. Activation of fibrinolysis was observed in female mice, both normoglycemic and diabetic. DAPA reduced thrombus formation in diabetic male and female mice, and decreased platelet activation to ADP and fibrin formation in diabetic male mice. DAPA increased fibrin formation in normoglycemic female mice and activated fibrinolysis in diabetic female mice. CANA and DAPA exerted sex-specific effects, which were more pronounced in hyperglycemia. The antithrombotic effect of CANA and DAPA was more noticeable in male mice and could be due to platelet inhibition. The effect on coagulation and fibrinolysis was not clear since an increased coagulation and fibrinolysis were observed only in female mice.

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Sex difference in clot lysability and association to coronary artery calcification

Cited by 9 publications

References 40 publications

Reductions in plasmin inhibitor and fibrinogen predict the improved fibrin clot lysis 6 months after obesity surgery

Reductions in plasmin inhibitor and fibrinogen predict the improved fibrin clot lysis 6 months after obesity surgery

Fibrin clot properties in coronary artery disease: new determinants and prognostic markers

Sex-dependent effects of canagliflozin and dapagliflozin on hemostasis in normoglycemic and hyperglycemic mice

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